Organization
KENTUCKIANA GASTROENTEROLOGY PSC
Active
Other names
Tricounty Gastroenterology
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ANAND GUPTA MD (OWNER)
(502) 893-7744
Entity
Organization
Contact information
Practice address
1003 N DUPONT SQ # 9A, LOUISVILLE, KY 40207-4612
(502) 893-7744
(502) 893-7741
Mailing address
1003 N DUPONT SQ # 9A, LOUISVILLE, KY 40207-4612
(502) 893-7744
(502) 893-7741
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
33458
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
24420293000
PASSPORT ADVANTAGE
KY
01
—
50015404
PASSPORT HEALTH
KY
05
—
64343585
—
KY
Enumeration date
03/19/2008
Last updated
03/06/2020
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